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Current Events => The DUmpster => Topic started by: thundley4 on December 21, 2009, 10:44:21 PM

Title: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: thundley4 on December 21, 2009, 10:44:21 PM
Quote
madfloridian   (1000+ posts)             Mon Dec-21-09 03:21 PM
Original message
Payments for cardiovascular Medicare patients may go down by 50% under HHS new rules on January 1.   
   

I had heard about this previously, but this letter today by two doctors today is really quite alarming. They have been to DC to talk to the WH about it, but have gotten nowhere.

I can not imagine this is happening, and it is being done without public debate or approval.

Medicare Fee Rule for Cardiovascular Care to Raise Costs, Cut Access

On Jan. 1, Medicare patients across the state of Florida will confront a new reality in cardiovascular care. The Obama administration released the final 2010 Physician Fee Schedule on Nov. 1, severely cutting cardiovascular payments for Medicare patients - some by as much as 50 percent. These cuts have nothing to do with the battle over health care reform currently taking place in Congress.

This new rule has taken place without public debate or approval. The cuts have been mandated by the Centers for Medicare and Medicaid Services under the direction of Health and Human Services Secretary Kathleen Sebelius. These are the primary tools for early diagnosis and treatment of cardiovascular disease. Many of the tests will now be done in a hospital where the costs (and co-pays) are higher.

Such drastic cuts will inevitably force some cardiology offices to close because the cost of equipment, supplies, and salaries for office staff cannot be sustained.

..."On Dec. 8, members of the Florida Chapter of the American College of Cardiology travelled to Washington to urge Congress and the White House to stop the implementation of the fee schedule. Florida cardiologists have met with CMS to advocate against the implementation of this rule with no effect since July.
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7290730

Quote
leftstreet   (1000+ posts)           Mon Dec-21-09 03:22 PM
Response to Original message
1. And how does the HCR bill address this?
   

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madfloridian   (1000+ posts)             Mon Dec-21-09 03:24 PM
Response to Reply #1
2. Apparently has nothing to do with it.   
   
I guess CMS answers only to HHS...and HHS answers to..?
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chandler2 (179 posts)           Mon Dec-21-09 03:24 PM
Response to Original message
3. I am so glad that I voted for change, aren't YOU? nt
   
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juno jones   (1000+ posts)             Mon Dec-21-09 03:25 PM
Response to Original message
4. K&R!
   
Medicare will be well and fatally defunded before any of us supposedly eligible poor folk get to participate.

Those savings that Lord Zero had to come from somewhere, but of course these are not part of HCR, just like the new recommendations for mammograms won't be followed under 0Bamacare. 

Rationing is starting without the bill being passed.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Carl on December 22, 2009, 06:22:43 AM
Good Lord,that thread has every element of DUmmy bitterness,envy,greed,stupidity and fascism on display.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: JohnnyReb on December 22, 2009, 07:24:46 AM
DUmmies aren't very bright.....they're going to kill off their voter base.

Conservatives will pay for their care while the DUmmies die off because it's not FREE.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Texacon on December 22, 2009, 08:57:07 AM
The liberals have not been paying attention.  As usual.

WE have been telling them MediCare and MedicAid are going broke.  What the hell do they think is going to happen?  It is either going to go away or; They are going to raise taxes to support it;  Cut services and fees paid;  A combination of those two.  They can't do it any other way.

Liberals fail because they are too stupid to follow these kinds of things to their logical conclusion.

KC
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS n
Post by: BEG on December 22, 2009, 09:02:37 AM
The liberals have not been paying attention.  As usual.

WE have been telling them MediCare and MedicAid are going broke.  What the hell do they think is going to happen?  It is either going to go away or; They are going to raise taxes to support it;  Cut services and fees paid;  A combination of those two.  They can't do it any other way.

Liberals fail because they are too stupid to follow these kinds of things to their logical conclusion.

KC

That is what I have always said, Liberals never think past the first "feel good" step.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Traveshamockery on December 22, 2009, 09:06:35 AM
I don't know - I think I'd like to go back to the days where people pay cash money for their own doctor visits and have health insurance for catastrophic illness. 

Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Oceander on December 22, 2009, 09:19:38 AM
I don't know - I think I'd like to go back to the days where people pay cash money for their own doctor visits and have health insurance for catastrophic illness. 



That ought to be an alternative open to everyone - just think how it would bring healthcare costs down.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Texacon on December 22, 2009, 09:36:05 AM
I don't know - I think I'd like to go back to the days where people pay cash money for their own doctor visits and have health insurance for catastrophic illness. 



There has been a rash of Dr.'s doing just that.  I would like to see it expand.  Part of the problem with that is getting the Dr.'s off the government/insurance/lawyer tit.  How many times do you go to the Dr. for something minor to have them schedule appt. after appt. for 'follow up' visits so they can collect the copay and a little something extra from the ins. co./medicare/medicaid?  Then you have folks like the DUmmies who will file suit if they don't get every test known to man to make sure the wart on their big toe is actually a bunion.

KC
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: thundley4 on December 22, 2009, 09:38:48 AM
I don't know - I think I'd like to go back to the days where people pay cash money for their own doctor visits and have health insurance for catastrophic illness. 



Unfortunately , most states have tons of mandates that insurance companies must cover. That is one thing that drives up premium costs.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: zeitgeist on December 22, 2009, 09:44:06 AM
DUmmies aren't very bright.....they're going to kill off their voter base.

Conservatives will pay for their care while the DUmmies die off because it's not FREE.

They will just import more. :cheersmate:
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Oceander on December 22, 2009, 09:46:12 AM
Unfortunately , most states have tons of mandates that insurance companies must cover. That is one thing that drives up premium costs.

I was thinking about that, but didn't want to fall over into a big essay.  The liberals keep lying on and on about increasing competition in the insurance industry and yet not a one will touch the one federal law that makes it possible for each state to set up a little quasi-monopoly and impose idiotic mandates with abandon:  the McCarran-Ferguson Act.  Get rid of that, permit the federal courts to knock most of the anti-competitive state laws down under the well-developed Dormant Commerce Clause body of precedent, and then stand back and let the competition begin.  Prices would start falling almost immediately.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: JohnnyReb on December 22, 2009, 09:59:33 AM
They will just import more. :cheersmate:

Yeah....that's why they want to make illegals citizens....more democrat voters.



Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: zeitgeist on December 22, 2009, 10:00:30 AM
I don't know - I think I'd like to go back to the days where people pay cash money for their own doctor visits and have health insurance for catastrophic illness. 



Sounds like you are endorsing the theory of increased co-pays which remind me of the concept of deductibles on auto insurance, the higher the deductible the lower the cost. Have a serious accident I am covered for the loss, a minor fender bender or door ding gets paid out of pocket.  Of course sometimes you lose but mostly if you own the vehicle free and clear and keep a high deductible you make out on the cost.  Health insurance should be priced the same way.  
I have been to the doctor recently for a shoulder problem.  I have a co pay then get an accounting from the insurance company of what they pay followed by a bill for the remainder from the physicians.  I would gladly pay a higher co-pay to reduce the administrative cost as long as I know I will be covered in the event I need major surgery ( which I am informed because of age is not a option).  But then I don't believe I deserve free health care if for no other reason than I exist.  Nor do I think my mechanic should work for free.  Silly me. :hammer:
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Karin on December 22, 2009, 10:37:28 AM
One of my favorites has never heard of John Galt: 

Quote
AngryAmish  (1000+ posts)        Mon Dec-21-09 03:27 PM
Response to Original message
5. Looks like a few cardiologists will have to make do without a new boat in 2010
 It must be so embarrassing at the yacht club not to be able to get a new boat every year. Like reusing toilet paper or something.

Quote
AngryAmish  (1000+ posts)        Mon Dec-21-09 03:34 PM
Response to Reply #16
20. Thus a doctor is presented with a choice: treat Medicare patients or be greedy

And he went on and on about the median salary for cardiologists being $282K.  I hope he desperately needs one someday.   :evillaugh:

Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Carl on December 22, 2009, 10:41:20 AM
One of my favorites has never heard of John Galt: 

And he went on and on about the median salary for cardiologists being $282K.  I hope he desperately needs one someday.   :evillaugh:



Then they all start declaring that the doc neeeds to make less..I am reading it saying to myself Efff you.
Who are they to dictate what anyone makes? :censored:

I would like to join that though and declare every DUmmy makes too much if they can afford Internet and needs to have less money.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Texacon on December 22, 2009, 10:53:50 AM
Then they all start declaring that the doc neeeds to make less..I am reading it saying to myself Efff you.
Who are they to dictate what anyone makes? :censored:

I would like to join that though and declare every DUmmy makes too much if they can afford Internet and needs to have less money.

Therein lies the problem.  Liberals think everyone makes too much except themselves.  I wish a very prosperous year to each and every one of them. 

KC
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Chump on December 22, 2009, 10:55:51 AM
Liberals are ****ing retarded.  They denounce the evils of their very own creation, that we've been decrying since the beginning, and then act like they never heard these complaints in the first place.  Morons.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Traveshamockery on December 22, 2009, 12:26:35 PM
I do believe I heard Sen Coburn say on the floor yesterday that after this goes into effect, you won't even be able to go to a doctor and pay cash for your care.  I cannot vouch for that because I was working while I was trying to listen.  It wouldn't surprise me, though.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: USA4ME on December 22, 2009, 08:12:24 PM
Quote from:
AngryAmish

5. Looks like a few cardiologists will have to make do without a new boat in 2010

It must be so embarrassing at the yacht club not to be able to get a new boat every year. Like reusing toilet paper or something.

This primitive is as stupid as they come.

Quote from:
SharonAnn

12. Me too. Now that doctors won't overcharge Medicare, more can be treated.

And that might be even more stupid.

I see one person on there spelled it out simply enough for even the primitives to understand.  Here's your answer, AngryAmish and SharonAnn primitives:

Quote from:
Thothmes
 
33. Or maybe they will decide not to treat medicare patients.

Quote from:
FLDCVADem
Response to Reply #33

48. we have a winner

That's exactly what will happen.

Yep.

.
 


Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: The Village Idiot on December 23, 2009, 02:18:19 PM
yep
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Oceander on December 23, 2009, 02:19:52 PM
Quote
Thothmes
 
33. Or maybe they will decide not to treat medicare patients.

We have a winner, folks!
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: bkg on December 23, 2009, 04:23:45 PM
We have a winner, folks!

Agree...

But that will end once the gov't demands they treat medicaire patients or lose their license all together. It WILL happen.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: thundley4 on December 23, 2009, 04:30:21 PM
Agree...

But that will end once the gov't demands they treat medicaire patients or lose their license all together. It WILL happen.

And that is why one poll had 40% plus of the doctors responding that they would consider retiring.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: bkg on December 23, 2009, 04:31:33 PM
And that is why one poll had 40% plus of the doctors responding that they would consider retiring.

And many will. Some, like most of us who need our jobs, will be forced to continue practicing.

Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Oceander on December 23, 2009, 08:49:00 PM
And many will. Some, like most of us who need our jobs, will be forced to continue practicing.



But even then, many will decide to find alternative careers, particularly those that still have some working years left.  After all, if auto mechanics are going to have a per-hour rate that is significantly higher than that of doctors, we may all find that we have Cuban-style healthcare, but Indy-500 style auto repairs.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: thundley4 on December 23, 2009, 09:10:34 PM
And many will. Some, like most of us who need our jobs, will be forced to continue practicing.



If enough doctors leave the profession, that will leave the remainder being overburdened.  That will also leave patients waiting much longer to be seen.  There are enough rich people in this country that they might start highering private doctors that are kept on retainer, much like lawyers.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: The Village Idiot on December 23, 2009, 09:22:17 PM
If enough doctors leave the profession, that will leave the remainder being overburdened.  That will also leave patients waiting much longer to be seen.  There are enough rich people in this country that they might start highering private doctors that are kept on retainer, much like lawyers.

which will be made illegal. People will end up going to Bermuda or Panama for their private care.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: thundley4 on December 23, 2009, 09:30:36 PM
which will be made illegal. People will end up going to Bermuda or Panama for their private care.

If I were a doctor I might look forward to retiring to the Bahamas and treating only wealthy American clients.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: diesel driver on December 24, 2009, 01:31:44 AM
But even then, many will decide to find alternative careers, particularly those that still have some working years left.  After all, if auto mechanics are going to have a per-hour rate that is significantly higher than that of doctors, we may all find that we have Cuban-style healthcare, but Indy-500 style auto repairs.

That will last until the government mandates that everyone get Indy-500 style auto care, all the while mandating the automakers produce Cuban-style autos....

Reagan had it right:  "Government isn't the solution to our problem.  Government IS the problem."

Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS n
Post by: VivisMom on December 24, 2009, 08:28:04 AM
Then they all start declaring that the doc neeeds to make less..I am reading it saying to myself Efff you.
Who are they to dictate what anyone makes? :censored:

I would like to join that though and declare every DUmmy makes too much if they can afford Internet and needs to have less money.

No kidding. Apparently the DUmpmonkeys have no idea how much it costs to become an MD, let alone one with a specialty in something like cardiology.

Then again, these people probably get their medical advice solely off of the intarwebz.  ::)
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: USA4ME on December 24, 2009, 08:40:42 AM
Agree...

But that will end once the gov't demands they treat medicaire patients or lose their license all together. It WILL happen.

I could see it being like a utility where a board of physicians petition for rate hikes.  Most doctors I know only have so many medicare patients they're willing to take at any one time anyway.  The gov't forcing a profession to do business with customers of which they don't want to do business will create problems in the "Law of Unintended Consequences" realm.

.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Karin on December 24, 2009, 08:41:13 AM
But Vivismom, the SoCal airhead thinks that the burdens of an expensive education is not a valid arguement for a decent salary.  She ridicules it before it's even mentioned.  

Quote
SOCALS (136 posts)      Mon Dec-21-09 10:06 PM
Response to Reply #34
38. Wait for people to start saying
 that doctors have to study for 12 years and... take loans to pay for education! Of course it justifies ripping off working Americans

Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Oceander on December 24, 2009, 08:49:41 AM
That will last until the government mandates that everyone get Indy-500 style auto care, all the while mandating the automakers produce Cuban-style autos....

Reagan had it right:  "Government isn't the solution to our problem.  Government IS the problem."



You'll get no argument from me on that point.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Oceander on December 24, 2009, 08:50:54 AM
I could see it being like a utility where a board of physicians petition for rate hikes.  Most doctors I know only have so many medicare patients they're willing to take at any one time anyway.  The gov't forcing a profession to do business with customers of which they don't want to do business will create problems in the "Law of Unintended Consequences" realm.

.

At some point it also devolves into indentured servitude, or more bluntly, slavery.
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Texacon on December 24, 2009, 09:21:23 AM
But Vivismom, the SoCal airhead thinks that the burdens of an expensive education is not a valid arguement for a decent salary.  She ridicules it before it's even mentioned.  



This from the same group of people constantly crying that they can't find a 'decent' job due to being 'over educated'.  This group won't take a job flipping burgers because it doesn't pay what their credentials warrant.

Go figure.

KC
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS n
Post by: VivisMom on December 24, 2009, 09:58:58 AM
But Vivismom, the SoCal airhead thinks that the burdens of an expensive education is not a valid arguement for a decent salary.  She ridicules it before it's even mentioned.  



OMG those kind of people piss me off to no end.

Bob wants to be a doctor. Bob goes to a nationally ranked, non-Ivy private school, and with no scholarships ends up graduating in four years with approximately 110K in debt. He applies to a number of medical schools, and ends up at a private medical school because it was cheaper than paying out of state tuition at a state school. In four years, he accrues 250K more in debt. After he graduates, he does a residency in cardiology (3 years) and then a fellowship (4 years.) Then he takes his final boards and is able to go into a private practice. He's accrued more than 360K in debt, and now has to pay 50K a year in malpractice insurance.

I'm sorry, but the people who dismiss the fact that medical school is expensive, and that being a doctor is hard, by saying they don't deserve what they earn are ****tards of the highest degree. Many doctors have loads of debt-especially the young ones, fresh out of school. As far as I am concerned, those doctors deserve every penny they earn.

I have a friend who was a GP in a private practice, and she was barely making enough to cover her living expenses-and she didn't live in a huge house or drive a Benz. Now she has a good job at a teaching hospital, but I'm pretty sure she doesn't consider herself rich or wealthy by and standard because she has a ton of debt to pay off.

SoCal, if you are reading this, FOAD.  :bird:
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS new r
Post by: Karin on December 24, 2009, 10:06:38 AM
They will FOAD, (and so will we) when there's no doctor to see them.  Who the hell would go to medical school now?  There are so many other things you could do with your brilliance that may pay far handsomer. 
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS n
Post by: VivisMom on December 24, 2009, 10:11:26 AM
I'm going to tell my kid to run for Congress...no work, no term limits, good benefits and good pay. Hell, any moron can be a Congressman-Al Franken did it!
Title: Re: Payments for cardiovascular Medicare patients may go down by 50% under HHS n
Post by: Texacon on December 24, 2009, 10:57:08 AM
I'm going to tell my kid to run for Congress...no work, no term limits, good benefits and good pay. Hell, any moron can be a Congressman-Al Franken did it!

H5!

LIFE TIME benefits.

KC

PS to add to your list of morons;

Nancy Pelosi
Harry Reid
Chucky Schumer
Henry Waxman
Dianne Feinstein ....